Opioids
Medications are only one part of your child’s pain management plan.
Opioids are strong prescription pain medications with the potential for serious side effects and complications. Common opioid names include oxycodone, hydrocodone, morphine, and codeine. It is important to know that codeine is not recommended for use in children.
Try Tylenol and Motrin first
Because of their risks, opioids are not usually the starting point to manage acute pain. Over-the-counter medications and non-medication techniques should be the first things used to manage acute pain. Together, they are often enough to manage your child’s pain. If an opioid is prescribed, it is usually only for management of breakthrough pain after surgery.
Breakthrough pain is severe pain despite over-the-counter medications and non-medication techniques. Know that even if you are using an opioid for breakthrough pain, you should still use the over-the-counter medications recommended and nonmedication techniques. This will allow you to use as little of the opioid as possible.
Some opioids already contain acetaminophen. If this is the case, your child may be unable to take over-the-counter acetaminophen with the opioid. Check the label and discuss this with your pharmacist.
Opioid side effects
Anyone who uses an opioid is at risk for these side effects:
Children who are overweight or have obstructive sleep apnea or snoring have a higher risk of sleepiness or slowed breathing from an opioid. Do not use opioids to help your child sleep.
Common Opioids Include:
| Generic Name | Brand Name |
|---|---|
| Fentanyl | Duragesic* |
| Hydrocodone | Vicodin®*, Norco®* |
| Hydromorphone | Dilaudid® |
| Methadone | Methadose® |
| Morphine | MS Contin®, Kadian |
| Oxycodone | Perococet®*, OxyContin® |
| Oxymorphone | Opana® |
| Tramadol | Ultram®, Ultracet®* |
* Contains acetaminophen (Tylenol). Use caution if you’re also taking acetaminophen separately.
OPIOIDS HAVE REAL RISKS
Anyone who uses an opioid, even for a short time, is at risk for dependence, tolerance, misuse, addiction, and overdose. Adolescents are especially at risk for opioid misuse and addiction because the parts of the brain that control impulsiveness and decision-making are still developing. (reference 19) In addition, peer pressure can also affect their behavior. Other factors that increase the risk of opioid use disorder include personal history of depression and/or anxiety and family history of substance use disorder.
Tolerance
When an opioid no longer has the same effect on your child’s pain as it first did, which means they need a higher dose to control pain. For example, if your child is taking an opioid which first worked well for pain, and then later it doesn’t work as well, it does not always mean the pain is worse. Instead, your child may have become tolerant to the opioid.
Dependence
When your child’s body has started to rely on the opioid to function. This can happen even with using an opioid for a short time period, but the longer your child takes an opioid, the higher the risk. This is one reason why it is important to use an opioid for as short a time as possible. Suddenly stopping an opioid when a person is dependent causes symptoms of withdrawal, such as muscle aches, yawning, runny nose and tearing eyes, sweating, anxiety, difficulty sleeping, nausea/vomiting, and/or diarrhea.
Misuse
When your child takes the opioid they were prescribed at a higher dose, more often, or for reasons other than which it was prescribed.
Addiction
When your child develops a brain disease known as Opioid Use Disorder (OUD). People with this condition seek and use opioids even though they are causing them harm.
Overdose
When your child takes a dose of medication that is too high for them. This affects breathing and can cause your child to stop breathing.
Diversion
When anyone other than your child gets and uses the prescribed medication. This can happen when you do not safely dispose of an opioid or leave it unattended. Diversion is dangerous because it can lead to misuse, overdose and/or opioid use disorder in others. Sharing or selling an opioid is a felony in the state of Michigan.
TIPS FOR REDUCING OPIOID RISK
- Tell your doctor about any other medications your child is taking and if your child has a history of opioid misuse or addiction, depression or anxiety, or a family history of addiction.
- Do not use opioids along with antihistamines such as Benadryl or sleep medications.
- Only use the opioid for the reason, dose, and frequency that it was prescribed, and use it for the shortest possible time period. If your child doesn’t need it, don’t use it and dispose of it properly.
- Write down what medications you’re giving your child and when. This will help you be sure you’re using the medication only as prescribed.
- Double-check dosing to make sure you’re giving only the amount prescribed.
- Watch your child for signs of side effects or complications, and if you notice them, contact your provider.
- Lock the opioid medication in a safe place. If you cannot lock it up, keep it out of common areas of the house.
- Do not share your child’s opioid with anyone else. It is a prescription only for your child.
- Dispose of any remaining medication in a safe way when your child has recovered. Keeping an opioid prescription in your home is risky. Children may accidentally take it and overdose, and others may find it and misuse it. Ask your pharmacy if they have home drug deactivation/disposal kits to give you so you can safely dispose of your medication.
Next Page: Non-Medication Options